Mr Brendan Stack, LPC, LADC - Medicare Counselor in Southbury, CT

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Mr Brendan Stack, LPC, LADC is a medicare enrolled "Counselor - Professional" provider in Southbury, Connecticut. He graduated from healthcare school in 2018 and has 8 years of diverse experience with area of expertise as Mental Health Counselor. He is a member of the group practice Southbury Adolescent And Young Adult Counseling Center and his current practice location is 519 Heritage Rd Ste 2a5, Southbury, Connecticut. You can reach out to his office (for appointments etc.) via phone at (518) 610-4528.

Mr Brendan Stack is licensed to practice in Connecticut (license number 4530) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1316403892.

Contact Information

Mr Brendan Stack, LPC, LADC
519 Heritage Rd Ste 2a5,
Southbury, CT 06488-6694
(518) 610-4528
Not Available

Map and Direction


Healthcare Provider's Profile

Full NameMr Brendan Stack
GenderMale
SpecialityMental Health Counselor
Experience8 Years
Location519 Heritage Rd Ste 2a5, Southbury, Connecticut
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Mr Brendan Stack graduated from medical school in 2018
  NPI Data:
  • NPI Number: 1316403892
  • Provider Enumeration Date: 02/20/2019
  • Last Update Date: 07/18/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 5092211243
  • Enrollment ID: I20251006001823

Medical Identifiers

Medical identifiers for Mr Brendan Stack such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1316403892NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
101YA0400XCounselor - Addiction (substance Use Disorder) 001323 (Connecticut)Secondary
101YP2500XCounselor - Professional 4530 (Connecticut)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Southbury Adolescent And Young Adult Counseling Center519322134915

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Brendan Stack allows following entities to bill medicare on his behalf.
Entity NameSouthbury Adolescent and Young Adult Counseling Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1235737735
PECOS PAC ID: 5193221349
Enrollment ID: O20251006001682

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Brendan Stack is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mr Brendan Stack, LPC, LADC
127 Watertown Rd,
Middlebury, CT 06762-1502

Ph: (518) 610-4528		Mr Brendan Stack, LPC, LADC
519 Heritage Rd Ste 2a5,
Southbury, CT 06488-6694

Ph: (518) 610-4528

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.